SCIENTIFIC INTEGRITY INSTITUTE

Research Example

There is an excellent example of the type of original research on a weak and controversial epidemiologic relationship that can be conducted by the Scientific Integrity Institute. This example is the May 17, 2003 British Medical Journal (BMJ) study conducted by me and Dr. Geoffrey C. Kabat and entitled “Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98” (http://bmj.com/cgi/reprint/326/7398/1057.pdf). It is the largest and most detailed epidemiologic study on the relationship between environmental tobacco smoke (ETS) and mortality ever published in a major medical journal, such as, the BMJ. It was subjected to thorough peer review by two highly regarded epidemiologists and to careful evaluation by the BMJ editorial board (http://bmj.com/cgi/content/full/326/7398/1057/DC1). An accompanying editorial by a prominent epidemiologist described the importance of the paper (http://bmj.com/cgi/reprint/326/7398/1048). The BMJ Editor commented on his decision to publish the paper (http://bmj.com/cgi/content/full/327/7413/505-a). It was second highest ranked original research paper in the BMJ in 2003, based on the “Top tens from bmj.com” (http://bmj.com/cgi/content/full/328/7435/DC1).

Our study found no relation between environmental tobacco smoke (ETS) and tobacco related mortality among never smokers in California, although it did not rule out a small effect. These findings are similar to those of most of the other US studies that have related ETS to lung cancer mortality and coronary heart disease (CHD) mortality. These findings are also consistent with the fact that ETS is much more dilute than actively inhaled smoke and the fact that typical exposure to ETS is equivalent to smoking no more than 0.1 cigarettes per day. Active smoking of 0.1 cigarettes per day is not associated with a measurable increase in risk of lung cancer or CHD.

Nevertheless, our findings are considered controversial because they are not consistent with the consensus opinion of several influential review committees that ETS causes about a 25% increase in lung cancer and CHD mortality among never smokers. The controversy is best explained in a May 18, 2003 Sunday Telegraph (London) newspaper article by Robert Matthews (http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2003/05/18/nsmoke18.xml) and in a September 11, 2003 Scripps Howard News Service column by Michael Fumento (http://www.fumento.com/disease/smoking.html). In spite of claims by some that our study is flawed, to date no errors have been found in the study, its alleged flaws have not been substantiated with any actual evidence, and its scientific integrity has been vigorously defended, as described under Research Defense.